Nerve fibers in uterosacral ligaments of women with deep infiltrating endometriosis.
Endometriosis is a disease of high prevalence and enigmatic origin. One aspect not yet clarified is the relationship between endometriosis and nerve tissue.


OBJECTIVE
To evaluate, by immunohistochemistry, the presence of sympathetic and parasympathetic nerve fibers in the uterosacral ligament and adjacent connective tissue in women with deep pelvic endometriosis and women without endometriosis.


METHODS
Cross-sectional study (Canadian Task Force II).


METHODS
University Hospital. Obstetrics and Gynecology Department, Santa Casa Medical School, São Paulo, Brazil.


METHODS
We selected 49 patients, 20 of them with deep endometriosis in the uterosacral ligament and 29 patients without endometriosis. Secondary antibodies to NSE (pan-neuronal marker), NPY (that identifies sympathetic nerve fibers), and VIP (that identifies parasympathetic nerve fibers) were used for the immunohistochemistry analyses.


RESULTS
The immunohistochemical staining by the NSE antibody was positive in 40% of cases of women with endometriosis and in 20.7% of patients without endometriosis (non-significant). The immunohistochemical staining by the NPY antibody was positive in 60% of patients with endometriosis and in 20.7% of the control group (p=0.005), while staining by the VIP antibody was 60% in patients with endometriosis and 13.8% in patients without endometriosis (p=0.001).


CONCLUSIONS
Immunoexpression of NPY (sympathetic fibers) and VIP (parasympathetic fibers) is higher in women with deep pelvic endometriosis than in women without endometriosis.
Kelm Junior
Adolpho Roberto
AR
OB/Gyn Department, Santa Casa Medical School, Sao Paulo, Brazil. adolphojr@uol.com.br
Lancellotti
Carmen Lucia P
CL
Donadio
Nilson
N
Auge
Antonio Pedro F
AP
Lima
Sonia Maria Rolim R
SM
Aoki
Tsutomu
T
Ribeiro
Paulo Ayroza
PA
D000328:Adult; D003430:Cross-Sectional Studies; D004715:Endometriosis / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008022:Ligaments / Q000294:innervation*; D009412:Nerve Fibers / Q000737:chemistry*; D009478:Neuropeptide Y / Q000032:analysis; D010751:Phosphopyruvate Hydratase / Q000032:analysis; D012447:Sacrum / Q000294:innervation; D014599:Uterus / Q000294:innervation; D014660:Vasoactive Intestinal Peptide / Q000032:analysis
D009478:Neuropeptide Y; D014660:Vasoactive Intestinal Peptide; D010751:Phosphopyruvate Hydratase